Individual
TIAH LANAE BOOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
900 MIX AVE APT 28, HAMDEN, CT 06514-5107
(203) 444-7019
Mailing address
900 MIX AVE APT 28, HAMDEN, CT 06514-5107
(203) 444-7019
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
CT
363A00000X
Physician Assistant
Primary
—
NY
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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